Here’s a rather prophetic story I wrote for the Fall 2004 issue of the Harvard Public Health Review. It outlines health reform principles discussed in Getting Health Reform Right: A Guide to Improving Performance and Equity, a book written by four Harvard professors, presumably for developing nations. But, maybe not.

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Four HSPH experts highlight the importance of social values, politics, organization, and economic considerations to health system reform in a new book, Getting Health Reform Right: A Guide to Improving Performance and Equity. Published by Oxford University Press, the uniquely multidisciplinary "repair manual" takes reformers step by step through the complexities of patching up and replacing broken systems.

"The world is littered with failed reform efforts," observes Marc J. Roberts, one of the quartet and a professor of political economy and health policy. But given the enormous needs, notes his colleague, Peter Berman, professor of population and international health economics, "We have no choice but to do better."

Despite what the United States spends to stay healthy--about $1.5 trillion a year, more than any other nation--this country ranked 37th among Western nations in one 2000 World Health Organization report that factored in quality and disparities in care among the insured and uninsured. When you consider that 2.8 billion people--more than half the population of all developing countries--live on less than $2 a day, you get an inkling of how little people in, say, Tanzania or Honduras have to spend on medical care, let alone prevention. If a wealthy, stable country like the U.S. can't provide good health services to all its citizens, what can resource-poor countries hope to accomplish?

I've never trusted ophthalmologists who don't wear glasses, or dentists with perfect teeth.

I mean, how can someone with perfect vision understand what it's like to be nearsighted? And, how do you describe a toothache to someone who’s never had a cavity?

When Dartmouth Medicine Magazine offered me a chance to interview doctors who had been severely injured or sicker than many of their patients, I jumped at the chance. It’s no exaggeration to say that the resulting story changed my life. I met some of the most amazing people, and will never again assume a doctor doesn’t understand my pain, or fear, or embarrassment.

See what you think:

The nightmare runs like this: One minute you're schussing down a black-diamond ski trail, and the next you can't feel anything south of your neck. Or one minute you're stepping out of the shower to get ready for a big date, and the next, as you glance at yourself in the mirror, you gasp. What is that lump?

Every day, physicians see patients who have actually lived bad dreams like these. That's their job. But what happens when a physician experiences the nightmare?